Orthopedist, Hyderabad

Personal Statement

My favorite part of being a doctor is the opportunity to directly improve the health and wellbeing of my patients and to develop professional and personal relationships with them....more

My favorite part of being a doctor is the opportunity to directly improve the health and wellbeing of my patients and to develop professional and personal relationships with them.

More about Dr. Rammohan

Dr. Rammohan is one of the best Orthopedists in Adibatla, Hyderabad. You can visit him/her at Bristlecone Multi Specialty Hospital in Adibatla, Hyderabad. Book an appointment online with Dr. Rammohan on Lybrate.com.

Lybrate.com has a nexus of the most experienced Orthopedists in India. You will find Orthopedists with more than 43 years of experience on Lybrate.com. Find the best Orthopedists online in Hyderabad. View the profile of medical specialists and their reviews from other patients to make an informed decision.

according to ayurveda you are suffering from aamvata....this disease happens because of accumulation of aam(undigested food) in all body joints...and symptom occurs like stiffness...pain.....fever sometimes....swelling etc....there are medicines like maha jwarankush ras....ekangvir ras....vaat rakshak...agnitundi vati etc.....so take medicines you will feel good after some time

this back pain is due to no back exercise.... due to this muscle get stiff ....
when suddenly you get move fast that time this stiff muscle get break and pain start.....
in ayurved there is mentioned one procedure
KATI BASTI ....DO THIS FOR FIVE DAYS WITH MEDICATED OIL
if you want to do it you should do it under doctor observation ....
so consult ayurvedic doctor near you ...
you will definitely get good result ..

Stiffness & pain in back & other joints is quite a common condition.
Rule out diabetes & vit.D deficiency or any other metabolic disorder.
Sleep on a hard bed with soft bedding on it.
SPRING BEDS, FOLDING BEDS OR THICK MATRESS ARE HARMFUL
Use no pillow under the head.
Any way take
IBUPROFEN 200mg OD & SOS x 5days
CALDIKIND PLUS (mankind) 1 tab ODx10days
You will need other supportive medicines also.
Take multivitamins & other antioxidants along with.
Do back (spine) exercises
Make sure you are not allergic to any of the medicines you are going to take
Do ask for detailed treatment plan..Do not ignore. It could be beginning of a serious problem.

Hello Mr. lybrate-user
As per information provided by u, you are suffering from paraesthesias due to peripheral neuropathy. Cause ranges from diabetes, Vit. B12 Deficiency (most common cause in your case), lead poisoning, etc.
Get Vit. B12, serum lead estimation.
Life-style changes: Get fresh juices and proteins in breakfast. Always take breakfast, lunch, and dinner on time. Try to sleep at night on time. Daily walk briskly for 30 minutes daily.
Kindly get the investigations done and then consult me, as I can't write medicines here. Thank you. Get well soon.

Hi
Thanks for your query and Welcome to Lybrate. I am Dr Akshay from Fortis Hospital, New Delhi.
Actually pain at calf/Leg region can be due to many reasons , commonly it is muscular in nature but it can also be due to Tendons, Nerves, Blood vessels etc.
My advise to you for initial 2-3 weeks will be :
- Ice packs application intensively with elevation of your limbs at night
- Take a short course of anti-inflammatory medication as per your body's suitability
- Stop your physical activity till pain completely subsides
- Intensive physical therapy, training and proper muscle conditioning once pain has subsided
- Slow resumption of physical activities with proper pre activity warm up and stretching of muscles and short increments in duration of physical activity each day as per pain tolerance.
- We will get some blood tests for you - Serum Vitamin D and serum Potassium levels, ESR and CRP
Once you have all these reports then you can contact me as i can advise you for proper supplementation
Do not hesitate to contact me if you need any further assistance.
You can also discuss your case and treatment plans with me in a greater detail in a private consultation.
Thanks & Regards
Dr Akshay Kumar Saxena
Consultant Orthopaedics
Fortis Hospital, New Delhi

Hi thanks for your query and welcome to lybrate. I am Dr. Akshay from fortis hospital, new delhi. To be very honest with you, if you are still having pain after 4 years of injury and seeing your age being very young, I will advise you to get x rays and mri of affected area to see the exact lesion and cause of pain. Do not hesitate to contact me if you need any further assistance.

Spondylitis includes swelling of the vertebra. It happens because of wear and tear of the ligament and bones found in your cervical spine, which is in your neck. While it is to a great extent because of age, it can be brought on by other reasons too. Side effects incorporate pain and stiffness starting from the neck to the lower back. The spine's bones (vertebrae) get fused, bringing about an unbending spine. These changes might be mellow or extreme, and may prompt a stooped-over posture. Some of the non-surgical methods to treat spondylitis are as follows-

Exercise based recovery/physiotherapy: Your specialist may send you to a physiotherapist for treatment. Non-intrusive treatment helps you extend your neck and shoulder muscles. This makes them more grounded and at last, relieves pain. You may neck traction, which includes using weights to build the space between the cervical joints and decreasing pressure on the cervical disc and nerve roots.

Medications: Your specialist may prescribe you certain medicines if over-the-counter medications do not work. These include:

Muscle relaxants, for example, cyclobenzaprine, to treat muscle fits

Opiates, for example, hydrocodone, for pain relief

Epileptic medications, for example, gabapentin, to ease pain created by nerve damage

Home treatment: In case your condition is less severe, you can attempt a couple of things at home to treat it:

Take an over-the-counter pain reliever, for example, acetaminophen or a calming medication, for example, Advil or Aleve.

Use a warming cushion or an ice pack on your neck to give pain alleviation to sore muscles.

Exercise routinely to help you recover quickly.

Wear a delicate neck prop or neckline to get transitory help. In any case, you shouldn't wear a neck brace for temporary pain relief.

Acupuncture: Acupuncture is a highly effective treatment used to mitigate back and neck pain. Little needles, about the extent of a human hair, are embedded into particular points on the back. Every needle might be whirled electrically or warmed to improve the impact of the treatment. Acupuncture works by prompting the body to deliver chemicals that decrease pain.

Bed Rest: Severe instances of spondylitis may require bed rest for close to 1-3 days. Long-term bed rest is avoided as it puts the patient at danger for profound vein thrombosis (DVT, blood clots in the legs).

Support/brace use: Temporary bracing (1 week) may help get rid of the symptoms, however, long-term use is not encouraged. Supports worn for a long time weaken the spinal muscles and can increase pain if not continually worn. Exercise based recovery is more beneficial as it reinforces the muscles.

Lifestyle: Losing weight and eating nutritious food with consistent workouts can help. Quitting smoking is essential healthy habits to help the spine function properly at any age.

ONCE THE CONSERVATIVE TREATMENT FAILS:

Early aggressive treatment plan of back & leg pain has to be implemented to prevent peripherally induced CNS changes that may intensify or prolong pain making it a complex pain syndrome. Only approx 5% of total LBP patients would need surgery & approx 20% of discal rupture or herniation with Neurologically impending damage like cauda equina syndrome would need surgery. Nonoperative treatment is sufficient in most of the patients, although patient selection is important even then. Depending upon the diagnosis one can perform & combine properly selected percutaneous fluoroscopic guided procedures with time spacing depending upon patient`s pathology & response to treatment. Using precision diagnostic & therapeutic blocks in chronic LBP , isolated facet joint pain in 40%, discogenic pain in 25% (95% in L4-5&L5-S1), segmental dural or nerve root pain in 14% & sacroiliac joint pain in 15% of the patients. This article describes successful interventions of these common causes of LBP after conservative treatment has failed.

NEED FOR NON-SURGICAL OPTIONS: Outcome studies of lumber disc surgeries documents, a success rate between 49% to 95% and re-operation after lumber disc surgeries ranging from 4% to 15%, have been noted. “In case of surgery, the chance of recurrence of pain is nearly 15%. In FBSS or failed back surgery the subsequent open surgeries are unlikely to succeed. Reasons for the failures of conventional surgeries are:

Multifactorial aetiologies of back & leg pain, some left unaddressed surgically.

EPIDURAL ADENOLYSIS OR PERCUTANEOUS DECOMPRESSIVE NEUROPLASTY is done for epidural fibrosis or adhesions in failed back surgery syndromes (FBSS). A catheter is inserted in epidural space via caudal/ interlaminar/ transforaminal approach. After epidurography testing volumetric irrigation with normal saline/ L.A./ hyalase/ steroids/ hypertonic saline in different combinations is then performed along with mechanical adenolysis with spring loaded or stellated catheters or under direct vision with EPIDUROSCOPE Sciatica gets complicated by PIVD with disco-radicular conflict causing radicular pain sometimes disabling. In this era of minimally invasive surgery lot many interventional techniques have evolved to address the disc pathology. We are still working for the ideal, safe & effective technique to tackle disco- radicular interphase. Here now we have devised a mechanical neuroplasty or foraminoplasty technique using an inflatable balloon tip catheter with guide wire via targeted transforaminal or interlaminar route aided by drugs instillation. Selected patients are procedured fluoroscopic guided with local anesthesia under prescribed sedation aseptically via preselected route depending upon location & type of PIVD causing root insult. First a suitable size needle is placed at desired site confirming with radiolucent dye through which hyaluronidase with saline or LA was injected. A flexible guide wire is passed at selected location & direction on which the inflatable balloon is threaded to the area of interest.

Adhesiolysis is achieved mechanically with inflating balloon for 10 seconds at a time & location. We inflated the balloon with contrast agent to have visualization of adhesiolysis & opening up of adhesions or root route. Here the balloon pressure & time has to be kept in minimum to avoid neurological damage, for which we inflate balloon for 10 seconds at a time. Close observation is made to balloon shape, pressure & patient`s response. Once dilatation is done the drug mixture of steroid with LA & or hynidase/ hypertonic saline is instilled over nerve in epidural space. We have logically used same approach for our Balloon Neuroplasty & foraminoplasty as it is safe & targets exactly the area of disco-radicular interphase or conflict. We can manage to address both the exiting and traversing nerve roots with single entry just by manipulating our guide wire to the place of offence. The procedure can be done via transforaminal route at level or level above or below, especially via S1 foramen. Now we are employing this technique for fresh cases coupling with Intradiscal decompression aided by instant disc retrieval by epidural balloon inflation with good results. The IDD is done by Coblation/ Laser/ DeKompressor or RF Biacuplasty. There is scope of coupling this technique with endoscopic spine surgery. By adding “Balloon Neuroplasty” to the armamentarium of the interventional pain management many patients can be benefited & relieved of previously interventionally unmanageable disco-radicular pain including FBSS sufferers.

PERCUTANEOUS DISC DECOMPRESSION (PDD): After diagnosing the level of painful offending disc various percutaneous intradiscal procedures can be employed.

OZONE-CHEMONEUCLEOPLASTY: Ozone Discectomy a least invasive safe & effective alternative to spine surgery is the treatment of choice for prolapsed disc (PIVD) done under local anaesthesia in a day care setting. This procedure is ideally suited for cervical & lumbar disc herniation with radiculopathy. Total cost of the procedure is much less than that of surgical discectomy. All these facts have made this procedure very popular at European countries. It is also gaining popularity in our country due to high success rate, less invasiveness, fewer chances of recurrences, remarkably fewer side effects meaning high safety profile, short hospital stay, no post operative discomfort or morbidity and low cost. If despite the ozone therapy the symptoms persist, Percutaneous intradiscal decompression can be done via Transforaminal route with Drill Discectomy/ Laser or Coblation Nucleoplasty/ Biacuplasty/ Disc-FX / Endoscopic Discectomy are good alternatives before opting for open surgerical Discectomy; which has to be contemplated in those true emergencies, as mentioned above as the first choice. In Biacuplasty radiofrequency energy is used in bipolar manner heating & shrinking the disc & making it harder as well for weight bearing. It also seals the annular defect & ablates annular nerves relieving back pain. In Laser or Coblation Nucleoplasty energy is used to evaporate the disc thereby debulking it to create space for disc to remodel itself assisted by exercises.

DISC-FX & ENDOSCOPIC DISCECTOMY: In this novel technique A wide bore needle is inserted & placed sub-annular in post disc just under the disc protrusion. Disc is then mechanically extracted with biopsy forceps to empty the annular defect. This painful & sensitive annular defect supplied be sinuvertebral nerve is thermo-ablated with radiofrequency which also seals the defect to prevent & decrease recurrences. Next Higher procedure, Endoscopic Discectomy is done with endoscope put through sheath inserted via posterolateral transforaminal or posterior interlaminar approach. Mostly done under local anaesthesia its fast becoming standard of care for disc protrusion & extrusions causing spinal canal stenosis with root or cord compression with leg pain.

LASER DISCECTOMY done for closed bulging discs is an outpatient procedure with one-step insertion of a needle into the disc space. Disc material is not removed; instead, nucleus pulposus is debulked by evaporating it by the laser energy. Laser discectomy is minimally invasive, cost-effective, and free of postoperative pain syndromes, and it is starting to be more widely used at various centers.

SELD: Epiduroscopic laser neural decompression is considered an effective treatment alternative for chronic refractory low back and/or lower extremity pain, including lumbar disc herniation, lumbar spinal stenosis, failed back surgery syndrome with morbid adhesion neuritis that cannot be alleviated with existing noninvasive conservative treatment. This Procedure is done under vision via an epiduroscope inserted via Caudal canal or Transforaminally employing front or side firing Laser fibers &/or fine instruments. If you wish to discuss about any specific problem, you can consult a Pain Management Specialist.

It's nerve root block. Combination of medicines are injected at the site of pathology. This causes decrease in inflammation and swelling.
In properly selected patients, long term results are very good.